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advanced training by staff
• Increased competition from
other healthcare professions that
are able to promise and deliver
on better working conditions,
higher compensation, and
greater recognition.
• Lack of adequate funding for
enough schools and graduation
capacity to provide the needed
numbers of laboratory
professionals.
Resilient Leadership
As a result, these times call for
leadership that is more adaptive and
agile than ever before, i.e. resilient
leadership. This is leadership that
understands change, and can adapt
through creating an organizational
culture of resilience; going beyond
continuous quality improvement to
embrace change on an institutional as
well as departmental level, enabling
their laboratory operation to not only
survive but prosper and grow.
safety and productivity concerns.
Quality work processes are not static
properties of an organization,
embracing resilience reflects a
dynamic effort to maintain quality.
A culture of resilience
A culture of resilience recognizes the
value of the laboratory staff, the stresses
that they may be experiencing, the
training that is needed, and the need to
be supportive and understanding. It
goes beyond a culture of continuous
quality improvement to include trust,
teamwork, tolerance, and a global
perspective that more change is
inevitable. The properties necessary for
resilient organizations include:
Top Management commitment:
to recognize performance concerns
and addresses them with continuous
and extensive follow-through based on
applying competency improvement
processes utilizing coaching and
management observation.
Key management strategies
Resilient Laboratories
include: providing staff with key
These are laboratories that are able to information about future plans for the
respond effectively, and adapt to all
development of the laboratory, and
kinds of changes in operation, internal involving the staff when possible; and
and external demands, and
determining how to implement these
expectations, through effective
changes through adjustments to job
planning and resource allocation, thus assignments; staffing levels; policies
allowing the continuation of normal
and procedures; management of
services without compromising quality. timelines and budgets.
Gaps in the continuity of healthcare
threaten a patient’s well-being and
The characteristics of a resilient
introduce the potential for adverse
laboratory include support for:
events. Whether, or how, a system
An open and fair culture: the
responds to fill such gaps in care
reporting of issues, problems, events,
continuity indicates its resilience.
and errors throughout the organization
Adaptations include new clinician
is supported and encouraged, but
initiatives, adaptive instrumentation,
culpable behaviors are not tolerated.
flexible staffing patterns, continuous
A Learning culture: Wherein issues,
quality improvement practices, and
problems, events, and errors are
institutional networking leading to
handled with an eye toward correction,
improvements in performance and
and solution, not denial; but not a
service. These approaches make up
“blame game” attitude either
the resilience that is built into the
Realism: Management is aware of
system to help accommodate demands any potential for serious problems
for care. Resilience provides the
and events due to weaknesses
means for organizations to target
inherent in their operation, and
resource investments by integrating
continuously monitor these.
Awareness: Management collects
ongoing data to gather insight into
quality of performance, problems,
and the state of safety defenses.
Utilizes the staff for feedback and
innovative ideas.
Flexibility: New or complex problems
are handled in a way that maximizes the
ability to solve the problem without
disrupting overall work.
Transparency: Management keeps
staff informed of all happenings,
both good and bad. This can open
up new avenues of discussion,
problem-solving, and team-building.
Resilience relies on constant
feedback from the staff regarding
the effectiveness of the changes
made by management. Additional
steps that enhance the ability of the
laboratory to successfully adapt to
these challenges include:
1. Encouraging two-way
communication
2. Recognize and reward
achievement.
3. Help employees succeed.
Provide employees with the resources
and support to do their work, and as
they show signs of readiness, be
willing to entrust them with new tasks
and greater responsibility.
1. Provide continuing education.
This should include a formal
orientation program, cross-functional
training, maintenance of professional
skills, coaching, career development,
and personal development.
Out of this develops a resilient
innovative workforce, one that is
capable of adaptively learning to
correct errors and to take advantage
of new opportunities (e.g., digital
technology; remote testing; ACOs), to
improve quality of service.
The end result is the leveling of
silos, enhancing communication,
creating a workforce that is not hesitant
to innovate and adapt to change; feels
appreciated and experiences less stress
when change is needed.
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